Evaluation of the End-stage Patients in Intensive Care

Abstract

Objective: The benefit of medical interventions applied in terminal patients who have no hope of recovery and whose death is thought to be approaching is still a controversial issue. In this study, it was aimed to analyze the terminal stage patients hospitalized in the intensive care unit. Materials and Methods: The general characteristics and laboratory results of 61 end-stage patients admitted to the adult intensive care unit of university hospital between December 2016 and may 2017 were examined. Life expectancy, mortality rates, factors affecting mortality, and costs per patient were evaluated according to the palliative prognostic index (PPI) and palliative care admission score (PCAS) of the patients. Results: Exitus patients had an average of 13.83 days of intensive care stay and patients who survived had a mean 30.69 days (p<0.05). The PCAS was not statistically significant between ex and alive patients. Exitus patients had a PPI of 6.48, whereas survivors had a PPI of 3.73, (p<0.05). Exitus patients had a mean palliative life expectancy of 3.78 days, whereas the palliative life expectancy of surviving patients was 71.42 days (p<0.05). The most common primary disease for intensive care admission is malignancy, with 33 patients. The average cost of treatment for exitus patients was $3654,50, while the cost of treatment for surviving patients was $7053,38 (p<0.05). Conclusion: End-stage patients should be admitted to the palliative care unit or hospice using prognostic scoring systems. The bed capacity in intensive care units should be used for patients who have a chance to be treated. It is thought that unnecessary health expenditures can be avoided by hospitalizing terminal patients in palliative care units and hospices.

Keywords

• end-stage patient
• palliative care
• intensive care unit
• cost